[Ultrasonographic features in the preoperative diagnosis of primitive fallopian tube carcinoma]. / Apport de l'échographie dans le diagnostic pré-opératoire des tumeurs malignes primitives de la trompe de Fallope.

ABSTRACT

OBJECTIVES: To review the characteristic ultrasound features of primary fallopian tube carcinoma (PFTC) and its relationship to the clinical history in order to establish specific findings useful for the preoperative diagnosis. METHOD: An extensive review of the current literature was done on Medline via PubMed by using the following keywords "primary fallopian tube cancer", "tubal cancer", "adnexal malignancy mass" and "ultrasound". RESULTS: PFTC corresponds to complex, sausage-shaped structures or cystic adnexal masses. A thick and an irregular capsule are in favour of a malignant lesion. Three-dimensional ultrasound is superior to 2D ultrasound for the detection of tubal wall irregularities such as papillary projections or pseudosepta who were suggestive of tubal malignancy and allows a better assessment of the extent of tumor infiltration through the capsule. Neovascularization with low resistance indices are typical of tubal malignancy. Three-dimensional power Doppler sonography acutely detected structural abnormalities of the malignant tumor vessels which are randomly dispersed within the papillary projections. Intra-uterine collection and peritumoral fluid are often found but ascite could be also an indirect proof of peritoneal carcinosis. CONCLUSION: Sausage-shaped structures or cystic adnexal masses associated with imaging findings such as papillary projections and neovascularization with low resistance indices are in favour of PFTC. A standardized terminology, high-frequency and 3D power Doppler could improve diagnostic performance by allowing a better assessment of tubal wall and chaotic vessels architecture of these tumors.